BOOK AND MEDIA REVIEWS
LITERATIM
Experiments and Observations
How William Beaumont and Alexis St. Martin
Seized the Moment of Scientific Progress
Howard Markel, MD, PhD
N
ESTLED ALONG THE CLEAR BLUE STRAITS BETWEEN
the great lakes called Michigan and Huron is an
oblong and verdant island. Centuries ago, the
Chippewa and Ottawa tribes named it Michili-
mackinac, or “the great turtle.” Referred to today as Macki-
nac but pronounced “Mackinaw,” this tiny land mass at-
tracts tourists by the millions seeking its calming waters,
grand hotels, attractive vistas, bicycle paths, and tons of a
sticky, sweet confection made of butter, milk, sugar, co-
coa, and a touch of vanilla, called Mackinac fudge.
In 1670, the French Jesuit missionary Father Jacques Mar-
quette and his intrepid interpreter Louis Joliet fled St. Ig-
nace, Michigan, to settle on the “Great Turtle” in the name
of their homeland.1 Less than a century later, in 1759, the
British took control of the island from the French and, in
1783, after signing the Treaty of Paris, Great Britain relin-
quished it to the fledgling United States, which had to de-
fend and regain it during the War of 1812. The French pur-
sued fur trapping there with vigor and cunning. But it was
John Jacob Astor, the first US multimillionaire, who put
Mackinac Island on the map in 1817, when Michigan was
admitted to the Union and Astor chose the island as the main
trading post of his fabled American Fur Company, a pelt
empire that spanned from the Great Lakes to the Missis-
sippi River.2
Every June, the American Fur Company hosted a con-
vention on Mackinac for thousands of trappers eager to sell
or barter the bounty they had hunted the previous winter.
The rest of the year, the island’s population hovered at a mere
500. Situated on the southeast cliff a few hundred feet above
the shoreline was a limestone fortress built by the British
in 1761 and subsequently occupied by the US Army to pro-
tect the island’s commerce and trade.3
In 1820, one of the military officers stationed there was
a young physician named William Beaumont. In 1810, he
began a 2-year apprenticeship to a well-established Ver-
mont physician named Benjamin Chandler and in 1812
passed his state’s qualification examination. That same year,
Beaumont enlisted with the US Army in search of adven-
ture and clinical experience and served as a surgeon’s mate
in the War of 1812. After the end of that conflict in 1815,
he resigned his post to set up a private practice in Platts-
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burgh, New York. Five years later, he turned his practice
over to a cousin and re-enlisted in the Army, which as-
signed him to Fort Michilimackinac.4
At this distant frontier outpost, Beaumont began the work
that culminated in a remarkable, if not outright revolution-
ary, book—Experiments and Observations on the Gastric Juice
and the Physiology of Digestion.5 But he hardly accom-
plished this gargantuan task alone. Indeed, Beaumont had
the help and the body of a French Canadian fur trapper
named Alexis St. Martin.
The story of Beaumont and St. Martin has been re-
counted so often it has acquired the finely burnished pa-
tina of hagiography. Yet even when stripped of its most sen-
sational layers, their collaboration remains an inspiring and
cautionary tale about the boundaries between physician and
patient and medical investigator and human participant.
On the morning of June 6, 1822, as the annual pelt swap-
ping jamboree was under way, a 20-year-old St. Martin waited
in line at the American Fur Company’s store to make some
trades. What began as a rudimentary exercise in capitalism
erupted into a medical emergency when a shotgun acciden-
tally discharged. As one eyewitness described, “the muzzle
was not over three feet from [St. Martin]—I think not more
than two. The wadding entered, as well as pieces of his cloth-
ing; his shirt took fire; he fell, as we supposed, dead.”6
The gun’s contents entered just under St. Martin’s left
breast, fractured several ribs, lacerated his diaphragm, and
left a gaping hole through which portions of the lung and
stomach protruded. Beaumont quickly arrived and admin-
istered first aid amid the stunning sights and smells of St.
Martin’s breakfast leaking from the wound. Thanks to Beau-
mont’s quick-witted and precise ministrations, St. Martin
did survive the event, albeit with a fistula leading directly
into his stomach that remained patent until his last day of
life. It was a medical intervention that would soon change
medicine.7
For much of the next few years, Beaumont provided daily
care and attention to his fascinating patient. Although the
wound partially healed, St. Martin remained weak and mis-
erable and refused any attempts by Beaumont to somehow
suture the hole shut. As a result of his critical injuries and
lengthy rehabilitation, St. Martin was also penniless.
Corresponding Author: Howard Markel, MD, PhD, Center for the History of Medi-
cine, University of Michigan, 100 Simpson Institute, Box 0724, 100 Observatory,
Ann Arbor, MI 48109-0725 (howard@umich.edu).
©2009 American Medical Association. All rights reserved.

Medical historians and ethicists have long argued over
Beaumont’s motives in caring for St. Martin. Alas, the his-
torical record obscures more than clarifies the physician’s
thinking and intent, as does the striking passage of time,
custom, and class, not to mention vast changes in the so-
cial understandings of the rights of patients and the obli-
gations of physicians. Assessing the motives and ethical im-
pulses of those long dead is a difficult task for even the most
adept historians. Clearly, Beaumont and St. Martin’s was a
complex relationship consisting of more than sympathy and
science. It also included ambition and careerism on Beau-
mont’s part; dependence and need from the ailing St. Mar-
tin; and a huge reserve of negative and positive human ac-
tions, emotions, and feelings that occupied both men in the
years to come.
On May 30, 1823, for example, Beaumont first recorded
his inkling that major scientific observations in this case were
possible after introducing a cathartic via a glass funnel into
St. Martin’s fistula and stomach. “I gave a cathartic, admin-
istered, it is presumed, as never medicine was adminis-
tered to man since the creation of the world.” The next day,
however, Beaumont described taking a destitute and sickly
St. Martin into his own home “from mere motives of char-
ity, and a disposition to save his life or at least to make him
more comfortable.”8
Others, however, have pointed out that a local woman
named Mary LaFleur first boarded St. Martin through the
spring of 1823, and it was not until after Beaumont discov-
ered the ease with which food and medications could be in-
serted into St. Martin’s stomach for further study that he ea-
gerly welcomed the trapper into his home.7
On August 1, 1825, St. Martin finally felt well enough to
allow Beaumont to formally begin the studies that served
as the basis of his soon-to-be famous book. As Beaumont
gleefully recorded, at “12 o’clock [noon], I introduced
through the perforation, into the stomach, the following ar-
ticles of diet, suspended by a silk string, and fastened at proper
distances, so as to pass in without pain-viz. A piece of high
seasoned a la mode beef; a piece of raw, salted, fat pork, a
piece of raw, salted, lean beef; a piece of boiled, salted beef; a
piece of stale bread; and a bunch of raw, sliced cabbage [ital-
ics Beaumont’s].”5(p125) During this and subsequent experi-
ments, Beaumont also withdrew copious amounts of gas-
tric fluids and chyme for analysis and elaboration.
Beaumont employed St. Martin as an aide and servant in
his subsequent military medical posts and continued to care
for him at his own expense. By the summer of 1825, how-
ever, St. Martin grew tired of being a human guinea pig and
abruptly fled to Canada. It was not until 1829 that physi-
cian and patient were reunited after St. Martin made a he-
roic canoe trip extending from northern Canada to Fort
Crawford in Prairie du Chien, Wisconsin, where Beau-
mont was stationed. A second series of experiments briefly
transpired until a homesick and tired St. Martin returned
to Canada. Many pleas and years later, the two met again
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LITERATIM
in Plattsburgh and Washington between 1832 and 1833 for
a final round of studies.
When Beaumont published his treatise in 1833, there was
great debate among the medical community about the pre-
cise mechanisms of digestion. Similarly, the lay public on
both sides of the Atlantic were obsessed with every episode
of dyspepsia, flatulence, and heartburn they experienced,
resulting in a huge demand for panaceas from their physi-
cians. Many medical experts advocated their own theory of
how humans digested their meals, but until Beaumont en-
countered the ailing St. Martin, no one had firsthand ac-
cess to a living, secreting stomach.9
Although sales were slow initially, Experiments and Ob-
servations eventually generated great excitement in Eu-
rope. By 1850, Beaumont enjoyed the status of being the first
US-born medical scientist to achieve international renown.
No less an authority than Claude Bernard, the Parisian physi-
ologist whose work led to the concept of homeostasis, cred-
ited Beaumont with initiating “a new era in the study of this
important organ and those associated with it.”10 Across Eu-
rope and beyond, physiologists looked for individuals with
similar fistulas or created them, experimentally, in animals
as they labored to elucidate the digestive process. Ironi-
cally, like so many prophets in their own land, in the United
States Beaumont’s theories were initially met with indiffer-
ence by a medical profession less enthralled with scientific
method than their peers in Britain, France, and Germany.
By the mid-19th century, however, even his countrymen re-
considered and initiated a cult of hero worship that re-
mains intact to the present day.4,7,10-12
After the publication of Experiments and Observations,
Beaumont hoped to conduct another round of experi-
ments, but St. Martin refused all such requests. The con-
stant poking and insertion of food, drinks, medications,
tubes, and thermometers into his fistula was hardly enjoy-
able, let alone comfortable. Moreover, he missed his family
and life in Canada and had experienced the ravages of
alcoholism.
St. Martin’s refusal to cooperate must have frustrated Beau-
mont; undoubtedly, Beaumont’s relentless coercion and
pleading irritated St. Martin. At various points in their col-
laboration, St. Martin demanded a formal contract. In re-
turn for allowing experiments to be conducted exclusively
by Beaumont, St. Martin received financial compensation,
medical care, and a modicum of respect and attention to his
wishes and comfort.7,13 Yet even after refusing additional ex-
periments with Beaumont in 1833, St. Martin steadfastly re-
buffed the requests of other scientists eager to employ him
in search of some additional data. In 1856, 3 years after Beau-
mont’s death, the financially strapped St. Martin finally did
consent to participate in a short-lived traveling exhibition
show with a quack physician named G. T. Bunting.14
After St. Martin died on June 20, 1880, his family kept
the body from being buried or embalmed for 4 days. The
corpse decomposed so badly that the odiferous coffin could
(Reprinted) JAMA, August 19, 2009—Vol 302, No. 7 805
 LITERATIM
not even be brought into the church. He was interred on
June 24, in a grave 8 feet deep and covered with 2 feet of
stones and another 6 feet of dirt to prevent medically inspired
grave robbers from exhuming his body for further inquiry.3
Apparently, St. Martin meant what he said when he told
his faithful and persistent healer William Beaumont that
enough was enough. Unlike the soil placed over his grave,
however, neither refusal nor death could cover the stun-
ning contributions he had already made to the medical lit-
erature and, more broadly, medical history. Both St. Mar-
tin’s wound and his willingness to work with Beaumont
literally opened the path for a field of study that continues
to benefit humankind to the present day.
Financial Disclosures: None reported.
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©2009 American Medical Association. All rights reserved.